Monday, September 23, 2019

A Whole New World

I guess it's been almost 2 weeks since my last post - which, to be fair, is probably the standard I should be setting for myself anyways. Finding time to write every week is challenging!

During those 2 weeks, we've had a very successful run of general surgeries, where we treated many a hernia and lipoma (soft tissue tumor). Our ward has by far been the least busy, with most of our patients going home day after surgery - allowing us to close completely over the weekends.

Things are about to change, however.

For the next 4 weeks we'll be home to the double load of MaxFax (Maxillo-Facial) patients that are about to roll in. Normally these all live on D Ward, but with two ORs and four surgeons rolling, their 15 beds will very quickly be MaxFaxed out (see what I did there...). We will be taking mainly less complex and/or more healed patients, but it will still be quite a different sort of nursing care. I've floated over to D Ward plenty of times, but there's just so many diverse types of MaxFax surgeries that there's still always new and unfamiliar things to learn. Though it does mean dealing with a good deal more saliva/drool than I'm used to...at least it also means I get to love on the little cleft lip kids like Saliou! He was the very first surgery done here in Senegal.


Hopefully soon I'll have more recent (post-op) photos of Saliou. He's cute as a button.

In the meantime, a couple pics from Deck 7 play time!

This cat looks cute but he can be a little bit of a troublemaker...

Bubbles & Jenga & Balloons - the Deck 7 Trifecta! (notice me hiding in the back?)

As we're stepping into this whole new world of MaxFax on A Ward, the Academy teachers shared a relatable rendition of the Disney classic during karaoke night a few days ago:



To adapt to hospital life, substitute "syringes" for "pencils" rolling away,  and "magic stretcher ride" for "magic lifeboat ride."

Also...this happened. 


It is fun to stay/work at the AFM. 

Right now I'm on an extended long weekend, which has been a nice time to unwind after 2 very busy weeks. I'll be starting into night shifts Wednesday to Sunday, though, so if anyone wants to catch up and chat, this is a good week for it! 

Substitute "shift work" for "traveling"
Well, that was a bit of a hodge-podge of a post, but hopefully by next time I'll have more patient pictures and stories to share.

À la prochaine,
-D

Wednesday, September 11, 2019

Speaking the Same Language

I just happened to start listening to the Come From Away soundtrack the other day. I haven't seen the show - didn't get the chance this past summer - but the soundtrack seems to tell just about the whole story.

If you don't know anything about it, Come From Away tells the story of the 38 aircraft that were diverted to the small town of Gander, NL on this day, 18 years ago. September 11th, 2001. There's some language in the soundtrack (they're Newfies after all), but it sure is powerful.

One of the songs struck a chord with me. Just for context, this is after the passengers were held on the tarmac (some for 28 hours), released (some after questioning), and carted off on busses (many still not knowing the day's events) to various community buildings. This particular moment between a passenger and a bus driver really gave me pause. Have a listen.


"And that's how we started speaking the same language."

Whew. What a little window into the confusion and fear of being in a foreign place surrounded by strange people speaking a strange language. So many of our patients must feel this way when they first come aboard. Fortunately, we have help in speaking the same language.

At Peace

Wolof is the language spoken by about 40% of Senegalese, along with a number of variant dialects, and a couple dozen other languages in various regions inland. In Dakar, an urban dialect of Wolof is spoken - a blend of Wolof, French, and Arabic. Coming from the strong Arabic & Islam influence, "Asalamalekum" is the most common greeting. Much of the language (particularly greetings) revolves around peace, and, as in most "hot cultures," greetings go beyond "Hi" and "how are you" to "how's your family, your home, your health, your journey, etc, etc, etc..."
Thanks to our lovely day crew I've picked up a few key phrases; ready for a survival Wolof primer?
Asalamalakum (Peace be upon you)
     Malekum salam (And you also) 
 Na nga def? (How are you?)
     Mangi fi / Mangi fi rek /Jamm rekk 
     (I'm here / I'm here in peace / I'm at peace) 
Jerrejef (Thank you - literally, "the act was worth it")
     Nyoko bok (No worries)
Baal ma (Excuse me), Massa (Very sorry)
Waaw (Yes), Deedeet (No)
There you go. Now you can survive - or at least bring some peace into the conversation - if you ever visit Dakar.

Be benen yoon ('Till next time),
-D

Saturday, September 7, 2019

Bedknobs & Broomsticks

I've been aboard two weeks now, and they've been full of cleaning, organizing, training, and planning.
The dream set-up team!
Cleaning every single duplo block...
Some nefarious person put 2 VERY similar looking syringes all together in a bag that I had to sort through...
Deep-cleaning everything, even the shower drains!

Week one there was a fairly small group of us (around 20 nurses); mostly alumni with a few first-timers; working to unpack, clean, and set-up the wards. Those who had sailed in from the Canaries were astounded as we were getting as much done in one day as they had managed the entire week before! With many hands, we had floors scrubbed & buffed, beds up, shelves stocked, and the hospital looking like an actual hospital, in no time.



Terrible photo of me, but the ward is looking great!

Of course, we had to keep ourselves entertained in the process. The antiseptic fumes may have contributed a bit too...


Towards the end of the week we got to meet our Ward Day Crew (the local staff who are hired to work as aides and translators) in a whirlwind of an afternoon. Small groups ran through our 11 stations learning about various duties, precautions, and protocols they would need to know to support our patients. We only had them for about 15 minutes (of mostly us talking), so it was a very brief introduction, but still exciting to meet them all. 

After a relaxing weekend, Monday morning brought the start of MASS NURSING ORIENTATION. About 30 more had arrived, some alum but mostly newbies, and they received a week of in-depth training to give them a good, solid start into the year. Nurses arrive & depart nearly every weekend throughout the field service, and most only get a day of in-class orientation, but this cohort will be setting the standard and orientating new arrivals themselves in the months ahead. I had a mixed bag of tasks in the meantime, attending and helping with some of the training sessions, while also helping to finish up the odds & ends still unfinished on the wards. 

Jenny & I repairing torn mattresses! They'll be used in the HOPE Center.

Delicious brunch put on by the hospital ward leadership
We also had some interesting events throughout the week, including a Hospital evacuation drill! This isn't something we would really be able to practice once there's real patients in the hospital, so the new nurses played patients and the rest of us assisted in their safe journey out onto the dock. Walking up 2 flights of stairs then down the steep gangway is not exactly easy for most post-op patients, so we use the pilot's entrance right in the middle of the hospital on Deck 3. I got to watch first hand from the eye room with my "cataract patients" as one of the deck crew opened the double-doors up and set out the narrow emergency gangway. Sietske (pictured below) and I then guided our patients across to safety on the dock. This was a full-ship drill, and screening was in full-swing on the dock, so there was quite an audience as the whole ship emptied out - some "patients" being carried out on stretchers, others with bandages and slings. 


Our patient & brave "eye patients"
Also last week was the Hospital Open House. This is a chance for the ~150 non-medical crew members on board, plus some of their children, to see what it's like to work in the hospital. Even the operating rooms were open to visitors (getting a thorough scrub-down after, of course). We had all kinds of activities for visitors to try out, including "eye surgery," injections, naso-gastric feeds, plaster casting, and emptying catheters. I had the role of a patient caregiver, which meant I was "sleeping" under the bed where the catheter needed to be emptied, and popped my head out every now and then to say hello. 

The Ponsetti method of progressive casting to correct clubfoot
Suzanne & Nicole - the "Women's Health patients" whose beds I was hiding under (it's apple juice)
Me and my "caregiver baby" - if a patient is breastfeeding, a family member needs to come with her to help care for baby
Visitors had to track down the right patient and medication record to give them their "pills"
Rahel being a *very* good sport to demonstrate a realistic ICU patient!

We spend the whole morning yesterday with our A Ward nurses & day crew yesterday, getting to know each other much better. The day crew are all lovely, and SUPER SMART (some of them have master's degrees!), a few are real jokesters, and I'm really looking forward to working with all of them. We have one gal, the rest are men - and she was a last-minute addition that we weren't expecting, so it was a nice surprise. They taught us lots of helpful Wolof phrases, which I'll share in another post.

Just as orientation wrapped up yesterday, I sat in on the chaplaincy presentation for the new nurses. While the chaplaincy team does, on the one hand, run the "church" on board, they are also here to support the crew emotionally, socially, and practically. They gave a lot of helpful tips on getting by in such a tight-knit community; there are also a couple of counselors available to support the crew. It's easy to feel both lonely and socially exhausted at the same time - which sounds counter-intuitive, but is very true. I'll end with a very insightful thought from that presentation:
"If you have to chose between being kind, and being right - chose kind. Then you'll always be right."                                                                                                                                                                         - Tammy Dunne, AFM Chaplain

I'll not be able to take near as many pictures of my day-to-day after this weekend, as patients will be filling our beds starting Monday. I will, though, do my best to keep you all up to date as the Field Service switches in to high-gear! Surgery starts Tuesday, Sept 10th.

That's all for now,
À la prochaine,
-D